Jin Haiqin, Wu Lingsha, Huang Ping, Zheng Yeping, Sun Yan, Lu Qin, Meng Xiaoqin, Yu Zhifang
Department of Cardiology, The Second Hospital of Jiaxing, Jiaxing, China.
Front Cardiovasc Med. 2024 Nov 21;11:1412675. doi: 10.3389/fcvm.2024.1412675. eCollection 2024.
This study aims to explore the effect of a case management model that breaks through the temporal and spatial characteristics on the at-home phase II exercise rehabilitation of postoperative patients treated with percutaneous coronary intervention (PCI).
We used the convenience sampling method to select 103 patients with coronary artery disease (53 in the observation group and 50 in the control group) who were admitted to the Department of Cardiovascular Internal Medicine at the Jiaxing No. 2 Hospital in January 2022 and January 2023 and underwent PCI treatment as study subjects. Patients in the control group were managed by the conventional continuity of care model, and those in the observation group were managed by the case management model that breaks through the temporal and spatial characteristics. Both groups of patients were intervened and followed up for 6 months, comparing the adherence to home II exercise rehabilitation and regular follow-ups, coronary heart disease risk factor indexes, unplanned readmission rate, and the incidence of adverse cardiovascular events between the two groups of patients.
Exercise adherence and regular follow-up adherence of patients discharged from the hospital at 1, 3, and 6 months after PCI were higher in the observation group than in the control group ( < 0.05). The comparison of risk factor indicators of patients in both groups at 6 months after discharge with those of patients before discharge showed different degrees of improvement, and the difference was statistically significant ( < 0.05). However, the difference in fasting blood glucose in the control group at 6 months after discharge compared with that before discharge was statistically significant ( < 0.05), whereas there was no statistical significance in the observation group ( > 0.05). The incidence of major adverse cardiovascular events and unplanned readmission at 6 months after discharge between the two groups was lower in the observation group than in the control group, and the difference was statistically significant ( < 0.05).
The case management mode that breaks through the spatiotemporal characteristics can improve the exercise adherence and regular follow-up adherence of post-PCI patients' at-home phase II exercise rehabilitation, which can effectively control the indexes of body mass index (BMI), triglyceride (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) and reduce the rate of unplanned readmission and the incidence of adverse cardiovascular events.
本研究旨在探讨一种突破时空特征的个案管理模式对经皮冠状动脉介入治疗（PCI）术后患者居家二期运动康复的影响。
采用便利抽样法，选取2022年1月和2023年1月在嘉兴市第二医院心血管内科住院并接受PCI治疗的103例冠心病患者（观察组53例，对照组50例）作为研究对象。对照组采用传统的连续性照护模式管理，观察组采用突破时空特征的个案管理模式管理。两组患者均进行6个月的干预和随访，比较两组患者居家二期运动康复的依从性和定期随访情况、冠心病危险因素指标、非计划再入院率以及心血管不良事件的发生率。
PCI术后1、3、6个月出院患者的运动依从性和定期随访依从性，观察组高于对照组（<0.05）。两组患者出院6个月时危险因素指标与出院前比较均有不同程度改善，差异有统计学意义（<0.05）。但对照组出院6个月时空腹血糖与出院前比较差异有统计学意义（<0.05），观察组差异无统计学意义（>0.05）。两组出院6个月时主要心血管不良事件发生率和非计划再入院率，观察组低于对照组，差异有统计学意义（<0.05）。
突破时空特征的个案管理模式可提高PCI术后患者居家二期运动康复的运动依从性和定期随访依从性，能有效控制体重指数（BMI）、甘油三酯（TG）、总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）指标，降低非计划再入院率和心血管不良事件的发生率。
